CRD summary

This CRD-conducted review concluded that, whilst recognising the limitations of the evidence presented, price increases should be used alongside other strategies to reduce cigarette smoking among young people (aged 25 years or under).

Objectives

To examine the impact of price on cigarette smoking in young people aged 25 years or under.

Review methods

Twenty databases (including MEDLINE, EMBASE, CINAHL, PsycINFO, BIOSIS Previews and ECONLIT) were searched from inception to June 2007. Searches were not limited by study design or language. Experts in the conduct of econometric studies and with an interest in the systematic review of econometric studies were contacted.

Eligible studies were those assessing the impact of price on smoking behaviour in young people aged 25 years or under, either by focusing on young people or by presenting the data separately for young people and adults.

Data from each study were extracted by one reviewer and independently checked for accuracy by a second reviewer. Due to heterogeneity between studies in terms of the sources of data, outcomes and modelling methods, formal meta-analysis was considered inappropriate and a narrative synthesis was undertaken. The studies grouped according to whether they used longitudinal, repeated cross-sectional data or cross-sectional data; within these groupings described in relation to the type of controls they used, in particular policy variables (such as restrictions of sales to young people) and indoor air regulations.

Where available, the differential impact of price by subgroups and evidence on the impact of cross-border purchasing of cigarettes on price elasticity estimates were also assessed. Smoking outcomes were categorised into participation, prevalence, levels of smoking, initiation, and cessation.

Results of the review

Forty-five studies met the inclusion criteria; 38 were from the USA, with only one study based in the UK. Thirty-four studies were specific to young people; 11 studies included adults and young people, but reported findings separately.

Nearly all studies were econometric analyses of survey data, so the evidence base was derived almost exclusively from the secondary analysis of observational data. Most studies failed to report adequate detail about the surveys, price (or tax) data, and the empirical methods used.

Bearing in mind the methodological limitations, the overall findings of the review suggested that price was an effective instrument in modifying the behaviour of young people. The evidence suggested that increases in price also induced reductions in smoking initiation and increased quit rates. However, there was heterogeneity in the size if the effect for each of these outcomes, with a range of estimated effects reported.

Conclusions

Price should be used as a legitimate instrument to be used alongside other policies aimed at reducing cigarette consumption among young people.

Funding

Department of Health Policy Research Programme, UK.

Bibliographic details

Rice N, Godfrey C, Slack R, Sowden A, Worthy G. A systematic review of the effects of price on the smoking behaviour of young people. UK: PHRC Project Outputs; A2-06. 2009.

Indexing Status

Subject indexing assigned by CRD

MeSH

Age Factors; Decision Making; Health Behavior; Humans; Smoking; Smoking Cessation; Taxes; Adolescent; Adult

AccessionNumber

12013060057

Database entry date

16/10/2013

Record Status

This is a high quality systematic review involving CRD that meets the criteria for inclusion on DARE. As CRD reviews are of high quality this structured abstract presents a brief summary of the review methods, the results and conclusions.